SC 040491

Inspection report children’s home: SC040132 1 SC040132 Registered provider: Cornwall Council Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This registered children’s home operates as a short-break service and is run by a local authority. It provides care for up to four children with learning disabilities. In total, there are 20 children on its register.

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Information about this children’s home

There is a suitably qualified and experienced manager in the home. The manager registered with Ofsted in April 2016.

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Information about this children’s home

Due to COVID-19 (coronavirus), at the request of the Secretary of State, we suspended all routine inspections of social care providers on 17 March 2020.

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and/or widespread failures that mean children are not protected or their welfare is not promoted or safeguarded.

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inadequate

Date of last inspection: 11 September 2019

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inadequate

Overall judgement at last inspection: good

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inadequate

Enforcement action since last inspection: none Inspection report children’s home: SC040132 2

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Inspection date Inspection type Inspection judgement

11/09/2019 Full Good 24/01/2019 Full Good 18/10/2017 Full Good 17/02/2017 Interim Sustained effectiveness Inspection report children’s home: SC040132 3

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inadequate

There is one child living at the home. The staff and managers are trying their best to meet this child’s complex needs. Despite this, serious failures have resulted in the child being exposed to risk of harm.

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inadequate

Poor management oversight, a lack of scrutiny of restraint practice, and gaps in the child’s records mean the risks are not being managed safely.

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inadequate

Recruitment processes for agency staff have failed to ensure that staff are suitably vetted. This means that the manager cannot be sure that staff working in the home do not present a risk to children.

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inadequate

Permanent staff lack experience in caring for a child who can become very distressed and aggressive. Staff are physically hurt and distressed by incidents. Some staff are away from work due to stress. Managers cover shifts and work very long hours. They are unable to effectively monitor the service as they are caring for the child.

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inadequate

The child cannot be placed with other children. As a result, all short-break services in this setting are on hold. This means arrangements have changed for some children who can no longer come to stay at the home for respite.

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inadequate

Staff work tirelessly to find interesting things for the child to do in the local area. A love of horses is supported by visits a local stables. Independence skills are developed by helping the child to bake and grow plants in the garden. Despite the challenges, staff create opportunities for developing social and practical skills.

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inadequate

Staff try hard to develop positive relationships and make the child feel valued. The child seeks out staff for affection and this is reciprocated appropriately. The child benefits from spending more time with family members since coming to live in this home. The child says he is happy. Trust is developing between the child and the adults caring for him.

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How well children and young people are helped and protected: inadequate

The child’s risk assessment is not up to date. It is not clear who is responsible for leading restraints. The child is restrained on the floor. However, the child’s risk assessment guides staff to use seated holds as holding the child on the floor is likely to be traumatic. The risk assessment is not updated after significant changes. For example, the document talks about tasks that should be led by a trained nurse. The nurse has stopped working in the home. A failure to update risk assessments means staff do not have the guidance they need to care for the child safely. Inspection report children’s home: SC040132 4 Four agency staff are on shift during the day, supporting two permanent staff. Agency staff are responsible for restraining the child. Staffing numbers have increased, but these arrangements have not been effective in preventing serious incidents. On two occasions the police were called to help manage the child’s

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How well children and young people are helped and protected: inadequate

behaviour. Members of the public have had their attention drawn to incidents in the community. The child and the staff have been filmed during incidents. This has resulted in agency staff feeling reluctant to restrain the child while out in public. This puts the child at risk.

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How well children and young people are helped and protected: inadequate

Restraint records are not sufficiently detailed. The child’s views are not sought and recorded following restraint incidents. Staff involved in restraining the child are not debriefed or supervised by the manager. Incidents are discussed during multi- disciplinary meetings and there is some analysis of triggers. However, there is insufficient scrutiny of restraint practice.

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How well children and young people are helped and protected: inadequate

On one occasion, the manager came into the home while off duty to give a child his prescribed medication. This is because there were no staff working in the home qualified in medication administration. This is not safe practice.

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How well children and young people are helped and protected: inadequate

Managers have not ensured that the physical environment is free from hazards. A garden spade was used as a weapon as it had not been stored securely. Damage in a child’s bedroom means a sharp metal panel is protruding from the radiator. Managers and staff had failed to take action to remove this. The radiator was fixed during the inspection at the request of the inspector.

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How well children and young people are helped and protected: inadequate

Agency staff from outside the local area work in the home. Due to lack of local accommodation, these staff stay in the home overnight while not on duty. These arrangements have not been risk assessed to ensure the safety of the child.

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The effectiveness of leaders and managers: inadequate

Managers and staff are tired. The situation they currently find themselves in is often overwhelming. Staff have raised concerns about the current arrangements with senior leaders. However, they said their concerns have not been acted upon.

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The effectiveness of leaders and managers: inadequate

Mangers work over their contracted hours covering shifts. They do their very best to support the staff team and sometimes support the staff while off duty. It is difficult for managers to complete their management duties while taking care of the child. As a result, there is not sufficient oversight of the service.

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The effectiveness of leaders and managers: inadequate

Agency staff are not suitably vetted. Checks have been delegated to the agency. There is no system in place to ensure the agency completes these checks to a satisfactory standard. The manager does not have sight of documentation to verify adults’ suitability to work with vulnerable children. This means managers cannot be sure the adults working in the home do not pose a risk to the children. The responsible individual has begun to put measures in place to address these failings since the inspection. Inspection report children’s home: SC040132 5 Team meeting minutes and staff supervision records document staff’s concerns about their own well-being and the safety of others. Some staff do not have regular supervision. Agency staff are not supervised by managers at the home. It is unclear what oversight there is of their practice. A lack of regular professional supervision prevents professional scrutiny and reflection of staff practice.

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The effectiveness of leaders and managers: inadequate

There has been a lack of progress since the last inspection with four requirements still unmet. These have been reinstated. A requirement was raised at the last inspection requiring alterations to be made to the kitchen door to enable wheelchair access. This work has not been arranged and the opening does not meet fire safety requirements. Inspection report children’s home: SC040132 6

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met; children receive advice, services and support in relation to their health and well-being.(Regulation 10 (1)(a)(b))

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Requirement Due date

In particular, staff must be able to respond to the emergency health care needs of young people effectively. Duty officers must have the relevant training and skills to meet the needs of young people. They must also be able to manage staff and to delegate important tasks effectively.

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Requirement Due date

This requirement was made at the last inspection and is restated. 17 September

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm and

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Requirement Due date

that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health. (Regulation 12 (1) (2)(b)(d))

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Requirement Due date

In particular, take action to make repairs to the home to ensure that the environment is safe and free from hazards. Securely store items that could be used as weapons and update the child’s risk assessments when required. Risk assess situations where adults not on shift are staying overnight in the home. 17 September Inspection report children’s home: SC040132 7 The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and promotes their welfare.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose;

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

ensure that the home has sufficient staff to provide care for each child;

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Requirement Due date

understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of the quality of the care provided in the home;

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(a)(c)(d)(f)(h))

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Requirement Due date

In particular, ensure that staff have the skills and sufficient staff to meet the individual needs of the child. Ensure that managers have the resources they need to deliver good- quality care to children living in the home and that there is sufficient oversight of staff practice and records.

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Requirement Due date

This requirement was made at the last inspection and is restated. 17 September

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Requirement Due date

The care planning standard is that children receive effectively planned care in or through the children’s home. (Regulation 14 (1)(a))

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Requirement Due date

In particular, care planning records must be kept up to date to ensure that staff are able to meet the current needs of young people.

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Requirement Due date

This requirement was made at the last inspection and is restated. 17 September Inspection report children’s home: SC040132 8 After consultation with the fire and rescue authority, the registered person must—

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Requirement Due date

provide adequate means of escape from the home in the event of a fire. (Regulation 25 (1)(b))

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Requirement Due date

In particular, the registered manager and senior leaders must drive forward plans that ensure the fire door in the kitchen area is accessible for wheelchair users.

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Requirement Due date

This requirement was made at the last inspection and is restated. 17 September

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

employ an individual to work at the children’s home; or if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home, if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

the individual is of integrity and good character;

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Requirement Due date

the individual has the appropriate experience, qualification and skills for the work that the individual is to perform;

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Requirement Due date

the individual is mentally and physically fit for the purposes of the work that the individual is to perform; and

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1) (2)(a)(b) (3)(a)(b)(c)(d))

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Requirement Due date

In particular, the manager should implement a system to complete the required checks on all staff working in the home, including agency staff. If these checks are delegated to someone else, the manager should have oversight of the information contained in recruitment checks in order to verify that adults working in the home do not pose a risk to children. 17 September Inspection report children’s home: SC040132 9 The registered person must ensure that—

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Requirement Due date

within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes—

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Requirement Due date

a description of the measure and its duration;

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Requirement Due date

the name of the person who used the measure ("the user"), and of any other person present when the measure was used;

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Requirement Due date

the effectiveness and any consequences of the use of the measure; and

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Requirement Due date

a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure;

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Requirement Due date

within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so ("the authorised person")

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Requirement Due date

has spoken to the user about the measure; and

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Requirement Due date

has signed the record to confirm it is accurate; and

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Requirement Due date

within five days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35 (3)(a)(iv)(vi)(vii)(viii)(b)(i)(ii)(c)(iv))

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Requirement Due date

This particularly relates to the recording of restraints. 17 September

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people, using the ‘Social care common inspection framework’. This inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC040132 10

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Children’s home details

Registered provider address: Accounts Payable, PO Box 727, Truro TR1 9GP

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Children’s home details

Responsible individual: Tony Phillips-Jones

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Inspectors

Angela Weston, Social Care Inspector Michelle Oxley, Regulatory Inspection Manager Inspection report children’s home: SC040132 11 to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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